Widespread skeletal brown tumor with rare elbow involvement and associated hydronephrosis in a case of primary hyperparathyroidism
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20242412Keywords:
Brown tumor, Primary hyperparathyroidism, Hydronephrosis, Elbow involvementAbstract
We report a rare case of primary hyperparathyroidism in a 32-year-old female caused by a parathyroid adenoma. The patient initially complained of left elbow pain. Imaging revealed multiple skeletal brown tumors affecting unusual sites such as the elbow, as well as multifocal involvement of the vertebrae, sternum, radius, ulna, humerus, femurs, pelvic girdle, and scapulae. An abdominal ultrasound further revealed hydronephrosis and renal calculi in the right kidney. This case highlights the uncommon widespread skeletal distribution and involvement of atypical sites by brown tumors, along with the rare complication of hydronephrosis.
References
Jagtap VS, Sarathi V, Lila AR, Bandgar T, Menon P, Shah NS. Brown tumor of the sternum: An unusual manifestation in a case of primary hyperparathyroidism. J Postgrad Med. 2011;57(2):149-52.
Mohammadi A, Mohebbi N, Roshanray L. Brown tumor: An uncommon manifestation of primary hyperparathyroidism. Casp J Intern Med. 2019;10(2):237-40.
Ullah E, Ahmad M, Ali SU, Redhu N. Primary hyperparathyroidism having multiple brown tumors mimicking malignancy. Indian J Nucl Med. 2012;27(2):114-7.
Reséndiz-Colosia JA, Rodríguez-Lozano AL, Flores-Díaz R, Baizabal-Olarte R, Lizárraga-Borges R, Gallegos-Cabriales EC. Maxillofacial brown tumor in chronic renal failure and secondary hyperparathyroidism. A case report. Gac Med Mex. 2008;144(2):165-9.
Jafari-Pozve N, Birang S, Torabinejad S, Eshghii S. Unusual manifestation of primary hyperparathyroidism with multiple brown tumors. Arch Iran Med. 2008;11(4):408-12.
Yamazaki H, Ota Y, Aoki T, Hosokawa R. Brown tumor of the maxilla and mandible in a patient with secondary hyperparathyroidism. J Oral Maxillofac Surg. 2003;61(10):1205-9.
Soundarya N, Sharada P, Prakash N, Pradeep G. Bilateral maxillary brown tumors in a patient with primary hyperparathyroidism: a case report and review of literature. J Oral Maxillofac Surg. 2011;69(8):e182-6.
Proença H, Castro Lopes J, Marques O, Fernandes G, Almeida R, Aguas F. Multifocal osteolytic lesions-a single clinical entity. BMJ Case Rep. 2013;2013:bcr2013009898.
Panagopoulos A, Tatani I, Kourea HP, Karanikolas M, Koukoulitsios G, Kalomiris K, Karayannopoulou G. Osteolytic lesions (brown tumors) of primary hyperparathyroidism misdiagnosed as multifocal skeletal metastases. Arch Osteoporos. 2018;13(1):122.
Fatma LB, Ezzahi H, Elbatoul A, Elkhanany A, Chbani L, Harroudi TE, Lamalmi N. Multifocal brown tumors revealing primary hyperparathyroidism: A case report. Radiol Case Rep. 2020;15(11):2263-8.
Ullah E, Mustafa M, Ahmad M, Akhter S, Mirza S, Mushtaq S, et al. Unusual presentation of primary hyperparathyroidism with multiple brown tumors masquerading as metastatic bone disease. Endocrinol Diabetes Metab Case Rep. 2019;2019:19-0087.
Vera L, Luciano PM, Mora M, Rua S, Dulín E, Roson M, et AL. Multifocal osteolytic lesions in primary hyperparathyroidism. J Clin Endocrinol Metab. 2013;98(10):3892-8.
Shetty AD, Namitha J, Shetty S. Bilateral maxillary and mandibular brown tumors in a patient with primary hyperparathyroidism. J Oral Maxillofac Pathol. 2018;22(1): S107-12.
Ullah E, Ahmad M, Ali SU, Naqvi AA, Abbas K, Khun S. Skeletal manifestations of primary hyperparathyroidism and the importance of bone scintigraphy for prompt management. Clin Nucl Med. 2014;39(9):759-62.
